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Is There an HRT Link?
A dramatic drop in the incidence of breast cancer may be due to millions of older women stopping hormone replacement therapy (HRT), recent research concludes.
Many women stopped taking hormones for their menopausal symptoms at the end of 2002, after a Women’s Health Initiative study was prematurely halted for safety concerns. It was widely reported that women taking an estrogen/progestin combo (such as Premarin or Prempro) had an increased risk of invasive breast cancer, as well as stroke, heart attack and blood clots. As a result, the number of hormone therapy prescriptions fell sharply from 2002 to 2003.
In a recent cancer statistics analysis, researchers at the M.D. Anderson Cancer Center in Houston found that in 2003, the incidence of breast cancer dropped by nearly 7% overall – a record single-year decline. Researchers also looked at 2004 data and found that as women’s use of HRT leveled out, so did breast cancer incidence.
The cancer decline, reported in the April 19, 2007, issue of the New England Journal of Medicine, was more evident in breast cancers that were estrogen-receptor positive, meaning tumors fed by estrogen. While other factors – such as mammogram statistics, diet and environmental factors – could have a bearing on the cancer drop, only hormone therapy use changed substantially between 2002 and 2003, leading researchers to conclude there is a link.
These findings have led doctors to heavily weigh the risks and benefits of hormones for their patients.
"You must tailor the approach to that particular patient," says Charles Cash, M.D., the chief of obstetrics and gynecology at Oakwood Hospital & Medical Center in Dearborn and medical director for Oakwood’s women’s health division. "If you have moderate to severe (menopausal) symptoms, these are to be addressed for the shortest period of time, in the lowest dosage, and then a weaning process occurs.
"If you’re looking at minimal symptoms, you don’t need to put yourself at risk for (breast cancer)," by taking HRT, Cash adds.